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83 Cards in this Set

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What 2 problems can every diarthrodial joint get?
OCD
DJD
How many joint capsules in the fetlock? The carpus?
Fetlock - ONE
Carpus - 2 capsules (radiocarpal; middle and carpometacarpal communicate)
What are the 3 anesthetic agents commonly used in equine joint/nerve blocks? Which has the fastest onset? Which has the longest duration?
Mepivicaine (last 1.5-2hrs)
Lidocaine (fast onset, last 30 min)
Bupivicaine (last 5-6 hrs)
Which block ONLY blocks the heels and sole?
Palmar digital nerve block
If you want to block the foot distal to the fetlock, which block is most appropriate? What nerves are affected?
Abaxial sesamoid block; affects palmar digital nerves and dorsal branches as well
Regarding the VAN triad on the abaxial sesamoid block, the nerve blocked lies...
a) more palmar/plantar
b) more lateral
c) in the center of the triad
d) palmar on the medial n. and lateral on the lateral nerve.
a) more palmar/plantar
Which block anesthetizes distal to the fetlock and INCLUDING the fetlock? Which nerves are blocked?
Low 4 point block
(blocks low palmar and low palmar metacarpal nerves)
Which block is used for the flexor tendons and distal check ligament?
High 4 point block
In which of the following blocks is swelling a possible sequel?
a) abaxial sesamoid
b) low 4 point
c) high 4 point
d) palmar digital
b) low 4 point
c) high 4 point
What joint block may be used to anesthetize the navicular bone?
Coffin joint block
What are normal values for WBC and protein in synovial fluid?
WBC 140-180 (10% neuts; 90% monos)
Prot 1.5-2
What are the joints of the carpus? Which ones intercommunicate?
Radiocarpal joint (separate)
Intercarpal & Carpo-metacarpal (communicate)
The coffin joint is commonly blocked medial and lateral to which structure?
Common digital extensor tendon
What are the main articulations of the tarsal joint? Which joints intercommunicate?
Tibiotarsal & Proximal intertarsal (communicate)
Distal intertarsal (separate)
Tarsometatarsal (separate)
What are the 3 major compartments of the stifle? Which of these communicate?
Femoropatellar & medial femorotibial (communicate)
Lateral femorotibial (separate)
The most commonly affected joint compartment of the equine stifle is...
Femoropatellar
Which of the following predispose the fetlock to injury?
a) large range of lateral motion
b) lack of soft tissue covering
c) 2 sesamoid bones
d) small cross sectional area of weight bearing surfaces
e) low range of motion
b) lack of soft tissue covering
d) small cross sectional area of weight bearing surfaces
(also LARGE range of motion)
Chronic thickening of the joint capsule without osseous radiographic lesions describes...
...green osslets
How is chronic proliferative synovitis treated?
Steroids + rest
Where do fractures tend to occur in P1? Which horses get them?
dorsal proximal margin on the medial side; more in racehorses
When should P1 fractures be treated? How are they treated?
Treat when fracture is causing a lameness (otherwise dont' treat); Tx via arthroscopic removal w/o curettage
Which breeds get sagittal and spiral P1 fractures?
Standardbreds
Where do sesamoid fractures occur and which has the best and worst prognosis?
Apical (best prognosis)
Mid-body (worst prognosis)
Basilar (bad prognosis)
What structures attach to the sesamoids?
Suspensory ligament proximally
Distal sesamoid ligaments distally
Intersesamoidean ligament
Which breeds get sesamoid fractures most often and where?
Thoroughbreds (right lateral forelimb)
Standardbreds (right lateral hindlimb)
Which radiographic view is best to see cannon bone condylar fractures?
DP view
Use DPMS 125 for evaluation of articular portion of fracture
Where do most condylar fractures of the cannon bone occur?
Lateral aspect; left front leg
What are the major articulations of the carpus? Which intercommunicate?
Radiocarpal (doesn't communicate)
Intercarpal
Carpometacarpal
(last 2 communicate)
What nerve, artery, and vein bundle is found on the medial side of the flexor tendons?
Medial palmar n, a, and v
T or F:
The majority of carpal motion is in the radiocarpal and middle carpal joints.
True!
How is "calf knees" treated? What serious sequel often occurs due to calf knees?
No treatment
Can cause chip fractures
Which carpal conformation puts stress on the sesamoids and suspensory apparatus? How is this treated?
Bucked knees (over at the knees)
Tx - corrective casting, splinting, tetracycline, or surgery
What is the difference between a chip and a slab fracture?
Chip = 1 joint surface
Slab = 2 joint surfaces
What is the most common slab fracture in the horse? What is the most common chip fracture?
3rd carpal bone (slab)
distal radiocarpal bone in middle carpal joint (chip)
T or F:
Anesthesia into the radiocarpal joint will not improve lameness in most chip fractures of the carpus.
True! Most chips are in the middle carpal joint (off of the distal radiocarpal bone)
How are carpal slab fractures treated?
Remove if <8mm; lag screw if larger
What is the most common problem diagnosed in the equine carpus?
Carpitis (DJD of carpus)
How is carpitis treated?
rest, maybe steroid joint injection (must REST w/steroids or degeneration gets worse)
Maybe HA
What is a fluid-filled bursa over the carpus? How is it treated?
Hygroma
Drainage, pressure wraps, maybe steroids, surgery, or cryosurgery
What should be done before treating any hygroma?
Ensure that it doesn't communicate with the joint!
What are the two major swellings over the carpus?
Hygroma
Synovitis of ECR sheath (just proximal to carpus)
Which needle sizes would be appropriate for local anesthesia? For intraarticular anesthesia?
Local (25 & 22ga)
Intra-articular (22-18 ga)
How do you say periostitis over the dorsal cannon bone in horse language?
Bucked Shins
Which structure prevents excessive dorsal flexion of the fetlock?
Suspensory ligament (interosseous muscle)
Which of the following are signs of type 1 bucked shins?
a) lameness
b) pain on palpation
c) thickening of dorsal cortex of cannon bone
d) young horses
e) fractures of dorsal cortex of cannon bone
b) pain on palpation
d) young horses
(usually no radiographic changes)
Which of the following are signs of type 2 bucked shins?
a) lameness
b) pain on palpation
c) thickening of dorsal cortex of cannon bone
d) young horses
e) fractures of dorsal cortex of cannon bone
a) lameness
b) pain on palpation
(usually older horses; can feel changes in cannon bone and get supberiosteal callus)
Which of the following are signs of type 3 bucked shins?
a) lameness
b) pain on palpation
c) thickening of dorsal cortex of cannon bone
d) young horses
e) fractures of dorsal cortex of cannon bone
a) lameness (obvious)
b) pain on palpation
e) fractures of dorsal cortex of cannon bone
(usually on middle to distal 1/3 of cannon)
What are saucer fractures associated with? How can you tell if the fracture penetrates into the medulla?
Type 3 dorsal cannon periostitis (see focal sclerosis within medullary canal = penetration)
What are treatment options for type 3 dorsal cannon periostitis?
Rest (4-6 months)
Shockwave
Sx (lag screw or forage)
Which condyle is most often fractured in the cannon bone? What are associated conditions with this?
Lateral condyle
Associated w/P1 fractures, DJD of the fetlock, and sesamoid fracture
How do you say "irritation and sprain of the interosseous ligament leading to periostitis" in horse-ese?
Splints
How is a splint treated?
NSAIDs
Rest (30-45d confinement)
Ice & pressure
Corrective shoes
Maybe steroids
Maybe US or Sx
What are indications for surgical removal of a splint fracture?
Sore (nonunion)
Infected
Impingement on suspensory ligament (big callus)
How are metacarpal/tarsal fractures treated?
Compression plates are best (one for young; 2 for adult)
What are the joints of the tarsus? Which ones communicate?
Tibiotarsal
Tarsometatarsal
Proximal and distal intertarsal
(Tibiotarsal and proximal intertarsal communicate)
Which tarsal bone spans both rows? Which way is the talus oriented?
4th tarsal bone spans both
Talus "points" laterally
The cunean tendon is an extension of which structure?
Split tendon from cranial tibial m.
Which tarsal joint moves the most?
Tibiotarsal joint
How is cunean bursitis treated?
NSAIDS
corrective shoeing
Training modification
Which joints does bone spavin affect? Which side?
Distal intertarsal and tarsometatarsal joints
(medial side)
Which of the following is NOT a treatment for bone spavin?
a) rest
b) steroid injection
c) surgical arthrodesis
d) NSAIDs
e) corrective shoeing
a) rest
If you see a horse move its rear legs in an arc from medial to lateral, what does it probably have?
Bone spavin
What conformation abnormalities may contribute to OA of the hock?
Sickle-hocked
Straight/upright hock
How do you say bursitis of the tuber calcaneus in horsespeak?
Capped hock
How is capped hock treated?
Behavior/environment modification
rest & NSAIDs
How do you say desmitis of the plantar ligament in horsespeak?
Curb
Why should your horse not eat false dandelions?
they'll get STRINGHALT
What are some differential diagnoses for a horse with hyperreflexia in the hind limbs?
Stringhalt
Old laceration near the hock
EPM
Which of the following is NOT associated with stringhalt?
a) unknown etiology
b) can be unilateral or bilateral
c) pain
d) involuntary flexion of the hock
c) pain
How is stringhalt treated?
Remove from pasture
Lateral digital tendonectomy
What is the horse-speak name for tenosynovitis of the DDF sheath proximal to the hock?
Thoroughpin
How is thoroughpin treated?
Drainage and pressure wrap
Steroids
Surgery???
What are the common areas for OCD in the hock? Which is most common?
DIRT (most common)
Lateral trochlear ridge
Either malleolus
What is horse-speak for OCD in the hock?
Bog spavin
If you find an OCD lesion in the hock, what should you do next?
Check the other hock!
What are the synovial compartments of the stifle, which is the largest, and which communicate?
Femoropatellar (largest)
Medial femorotibial
Lateral femorotibial
(first 2 often communicate)
Where does OCD in the stifle occur most often?
Lateral trochlear ridge
What are contraindications for stifle surgery due to OCD? What gives a bad prognosis for OCD here?
Young
No bone flaps
(patellar involvement is BAD)
What age is OCD in the stifle often seen? How about osseous cysts in the stifle?
OCD <2yrs
Cysts 2-4 yrs
Where do osseous cysts in the stifle occur?
Medial femoral condyle
An outward arc in rear-leg motion indicates pain in what area?
Stifle pain
T or F:
Stifle lesions will often not block out completely with intra-arthrodial anesthesia.
True!
How are OCD cysts treated?
Arthroscopic curettage
Steroids + bone marrow/stem cell aspirates or platelet-rich plasma